Key result
Intravenous ganciclovir therapy for 10 days led to marked clinical improvement and recovery of left ventricular ejection fraction from 35% to 75% in a 41-year-old immunocompetent man with CMV myocarditis.
Case Report (n=1)
This case highlights that primary CMV infection can cause severe acute myocarditis in immunocompetent adults, which may be successfully treated with ganciclovir and supportive heart failure therapy.
Alerts clinicians to possible treatable CMV myocarditis in immunocompetent adults; leaves open antiviral efficacy without controlled data.
BACKGROUND: Cardiac complications constitute a rare clinical manifestation of cytomegalovirus (CMV) infection. This virus is usually asymptomatic in immunocompetent individuals. We report a case of myocarditis and cardiac insufficiency due to primary CMV infection. Serological tests by using ELISA method showed positive results for the virus. CASE PRESENTATION: A 41-year-old man with no prior comorbidities presenting with dyspnoea, fever, and oedema was admitted to the cardiac emergency service. He had fever and dry cough, which aggravated into progressive respiratory distress, lower limb oedema, and orthopnoea 30 days prior to hospitalisation. The electrocardiogram revealed sinus tachycardia, first-degree right bundle branch block, and ventricular and left atrial overload as well as diffuse and nonspecific disturbances of ventricular repolarization. Serological tests were conducted, and IgM (1.54 UI/mL) and IgG (2.5 UI/mL) were found positive only for CMV by using ELISA. The patient was diagnosed with cardiac insufficiency due to CMV myocarditis. He was treated with ganciclovir for 10 days and received supportive medication. CONCLUSION: This case reaffirms the possibility of cardiac involvement in CMV infection and emphasises the importance of viral aetiologies as differential diagnoses for acute myocarditis.
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Palmeira et al. (2016) conducted a case report in Cytomegalovirus myocarditis (n=1). Ganciclovir was evaluated on Clinical and echocardiographic improvement. Intravenous ganciclovir therapy for 10 days led to marked clinical improvement and recovery of left ventricular ejection fraction from 35% to 75% in a 41-year-old immunocompetent man with CMV myocarditis.
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